Atorvastatin

(CC) Image: David E. Volk
Atorvastatin, a type II statin.

Atorvastatin, commonly called Lipitor, is a type II statin used to treat high cholesterol (hypercholesterolemia), prevent heart attacks and strokes, and to lessen the formation of artial plaque. It is a HMG-CoA reductase inhibitor that decreases the synthesis of mevalonate, a key chemical precursor of cholesterol. Although the structure is based on an indole ring, as are the other type II statins fluvastatin and rosuvastatin, its longer half-life and specificity for the liver makes atorvastatin a better drug for lowering LDL-cholesterol levels. The metabolites of atorvastatin, ortho- and parahydroxylated derivatives and various beta-oxidation products, are equivalent HMG-CoA reductase inhibitors. The drug should be taken with a low fat meal and alcohol and grapefruit juice should be avoided. Atorvastatin can be toxic, leading to liver problems, rhabdomyolysis and eye hemorrhages.

Its official IUPAC chemical name is (3R,5R)-7-[2-(4-fluorophenyl)-3-phenyl-4-(phenylcarbamoyl)-5-propan-2-ylpyrrol-1-yl]-3,5-dihydroxyheptanoic acid and it has chemical formula C₃₃H₃₅FN₂O₅.

brand names

• Cardyl
• Lipitor
• Sotis
• Torvast
• Tozalip
• Xavator
• Sortis
• Torvacard
• Totalip
• Tulip
• Xarator
• Atorpic
• Liprimar

Drug interactions

• Amprenavir can possibly increase the statin
• Atazanavir increases the effect and toxicity of the statin
• Bezafibrate increases the risk of myopathy/rhabdomyolysis
• Bosentan could decrease atorvastatin
• Carbamazepine decreases the effect of the statin
• Colchicine increases the risk of rhadbomyolysis with this combination
• Clarithromycin possibly increases the statin toxicity
• Cyclosporine may cause myopathy and rhabdomyolysis
• Delavirdine an NNRT inhibitor increases the effect and toxicity of the statin
• Diltiazem increases the effect and toxicity of atorvastatin
• Efavirenz, an NNRT inhibitor, increases the effect and toxicity of the statin
• Erythromycin possibly increases the statin toxicity
• Fenofibrate Increasing risk of myopathy/rhabdomyolysis
• Fluconazole Increases the risk of myopathy/rhabdomyolysis
• Fosamprenavir Amprenavir can possibly increase the statin toxicity
• Gemfibrozil Increases the risk of myopathy/rhabdomyolysis
• Imatinib increases the effect and toxicity of atorvastatin
• Indinavir increases the effect and toxicity of atorvastatin
• Itraconazole Increases the risk of myopathy/rhabdomyolysis
• Josamycin, a macrolide, possibly increases the statin toxicity
• Ketoconazole increases the risk of myopathy/rhabdomyolysis
• Nefazodone increases the effect and toxicity of the statin drug
• Nelfinavir increases the effect and toxicity of the statin
• Nevirapine, an NNRT inhibitor, increases the effect and toxicity of the statin
• Quinupristin presents an increased risk of toxicity
• Rifabutin, a rifamycin, decreases the effect of the statin drug
• Rifampin, a rifamycin, decreases the effect of the statin drug
• Ritonavir increases the effect and toxicity of the statin
• Saquinavir increases the effect and toxicity of atorvastatin
• Tacrolimus increases the effect and toxicity of the statin
• Telithromycin may possibly increase statin toxicity
• Verapamil increases the effect and toxicity of the statin